CTICasesProsthetic Aortic Valve Dehiscence with Gerbode Defect
Imaging findings
Chest radiograph and fluoroscopy show an abnormal, unstable, tilting orientation of a prosthetic aortic valve. Echocardiogram and CT confirm valve dehiscence and a high-flow Gerbode defect (left ventricular-to-right atrial shunt) secondary to endocarditis.
Key takeaways
Prosthetic valve endocarditis can cause destructive paravalvular tissue necrosis, leading to valve dehiscence (rocking valve). This can result in a Gerbode defect, which is a rare shunt connecting the high-pressure left ventricle directly to the low-pressure right atrium, causing acute heart failure.
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